Is Asking Questions on Rounds a Teachable Skill? A Randomized Controlled Trial to Increase Attendings' Asking Questions

Morning bedside rounds remain an essential part of Internal Medicine residency education, but rounds vary widely in terms of educational value and learner engagement. To evaluate the efficacy of an intervention to increase the number and variety of questions asked by attendings at the bedside and as...

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Bibliographic Details
Published in:Advances in medical education and practice 2020-01, Vol.11, p.921-929
Main Authors: Shields, Helen M, Honan, James P, Goldsmith, Jeffrey D, Madan, Rachna, Pelletier, Stephen R, Roy, Christopher L, Wu, Lindsey C
Format: Article
Language:English
Subjects:
Analysis
asking questions
bedside rounds
clinical reasoning
Education
Evidence-based medicine
Hospitalists
Hospitals
Internal medicine
Leadership
Nurses
Original Research
Patients
Pharmacists
randomized controlled trial
Teaching methods
teaching strategies
Womens health
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Summary:Morning bedside rounds remain an essential part of Internal Medicine residency education, but rounds vary widely in terms of educational value and learner engagement. To evaluate the efficacy of an intervention to increase the number and variety of questions asked by attendings at the bedside and assess its impact. We conducted a randomized, controlled trial to evaluate the efficacy of our intervention. Hospitalist attendings on the general medicine service were invited to participate. Twelve hospitalists were randomized to the experimental group and ten hospitalists to the control group. A one-hour interactive session which teaches and models the method of asking questions using a non-medical case, followed by practice using role plays with medical cases. Our primary outcome was the number of questions asked by attendings during rounds. We used audio-video recordings of rounds evaluated by blinded reviewers to quantify the number of questions asked, and we also recorded the type of question and the person asked. We assessed whether learners found rounds worthwhile using anonymous surveys of residents, patients, and nurses. Blinded analysis of the audio-video recordings demonstrated significantly more questions asked by attendings in the experimental group compared to the control group (mean number of questions 23.5 versus 10.8, p< 0.001) with significantly more questions asked of the residents (p
ISSN:1179-7258
1179-7258
DOI:10.2147/AMEP.S277008